Preparedness for emerging infectious diseases: pathways from anticipation to action

Abstract

Emerging and re-emerging infectious disease (EID) events can have devastating human, animal and environmental health impacts. The emergence of EIDs has been associated with interconnected economic, social and environmental changes. Understanding these changes is crucial for EID preparedness and subsequent prevention and control of EID events. The aim of this review is to describe tools currently available for identification, prioritization and investigation of EIDs impacting human and animal health, and how these might be integrated into a systematic approach for directing EID preparedness. Environmental scanning, foresight programmes, horizon scanning and surveillance are used to collect and assess information for rapidly responding to EIDs and to anticipate drivers of emergence for mitigating future EID impacts. Prioritization of EIDs - using transparent and repeatable methods - based on disease impacts and the importance of those impacts to decision-makers can then be used for more efficient resource allocation for prevention and control. Risk assessment and simulation modelling methods assess the likelihood of EIDs occurring, define impact and identify mitigation strategies. Each of these tools has a role to play individually; however, we propose integration of these tools into a framework that enhances the development of tactical and strategic plans for emerging risk preparedness.

Keywords: Environmental scanning; foresighting; horizon scanning; prioritization; risk assessment; simulation modelling; surveillance.

Fig. 1.

The relationship between information type and collection method, and the projected time-frame of activities for emerging infectious disease preparedness.

Fig. 2.

Steps of a foresight programme, modified from Horton [18] and Voros [23].

Fig. 3.

Flowchart of steps for disease prioritization using multi-criteria decision analysis (MCDA). Modified from Brookes et al. [56].

Fig. 4.

Framework for the integration of surveillance, horizon and environmental scanning, prioritization, risk assessment and disease modelling, to facilitate preparedness and response to emerging infectious disease events.